Hypoglycemia in Infants: Neurological Outcomes
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Questions and Answers

What is the main focus of Week 61 Dr. Deepak Manhas' discussion?

  • Pathophysiology of hypoglycemia in newborns
  • Long-term complications of neonatal conditions
  • Diagnosis and management of neonatal jaundice
  • Abnormalities in fetal-neonatal transition (correct)

In the neonatal period, what physiological event is critical for a smooth transition to extrauterine life?

  • Infection control
  • Respiratory distress
  • Maintenance of glucose homeostasis (correct)
  • Hyperbilirubinemia

What is the importance of defining hypoglycemia and hyperbilirubinemia in neonates?

  • To prevent maternal infections
  • To understand normal neonatal physiology (correct)
  • To identify signs of neonatal distress
  • To outline common pediatric diseases

Untreated hypoglycemia and hyperbilirubinemia in neonates can lead to:

<p>Neurodevelopmental delays (D)</p> Signup and view all the answers

What should healthcare professionals be able to do after discussing hypoglycemia and hyperbilirubinemia?

<p>Identify signs of these conditions in newborns (C)</p> Signup and view all the answers

Why is it necessary to discuss the management plans for neonatal hypoglycemia and hyperbilirubinemia?

<p>To ensure timely interventions for newborns (C)</p> Signup and view all the answers

What role does identifying abnormalities in transition play in neonatal care?

<p>It guides effective treatment strategies (C)</p> Signup and view all the answers

True or False: Neonatal Hypoglycemia is a common physiological event that occurs in most newborns.

<p><strong>False</strong> (D)</p> Signup and view all the answers

What type of light is most effective in phototherapy for neonatal jaundice?

<p>Blue-green light (460-490 nm) (D)</p> Signup and view all the answers

What is generated when normal bilirubin absorbs light during phototherapy?

<p>Photooxidation products (D)</p> Signup and view all the answers

How are configurational and structural isomers excreted from the body?

<p>Excreted in bile without glucuronidation in the liver (D)</p> Signup and view all the answers

What treatment is recommended for severe neonatal jaundice?

<p>Exchange transfusion (A)</p> Signup and view all the answers

What are potential complications of exchange transfusion?

<p>Heart &amp; lung problems (B)</p> Signup and view all the answers

Which factor can influence the severity of neonatal jaundice according to the text?

<p>Age and/or weight (B)</p> Signup and view all the answers

What causes erroneously low bilirubin levels in samples sitting in sunlight before processing?

<p>Sunlight causes the breakdown of bilirubin (D)</p> Signup and view all the answers

What is the main excretion route for photooxidation products?

<p>Mainly in urine (B)</p> Signup and view all the answers

What is the main source of energy for cerebral cells?

<p>Glucose (B)</p> Signup and view all the answers

Which hormone is associated with excessive insulin production and is a risk factor for neonatal hypoglycemia?

<p>Insulin (D)</p> Signup and view all the answers

What is the role of GLUT1 and GLUT3 in glucose supply to the brain?

<p>GLUT1 and GLUT3 transport glucose into the brain (C)</p> Signup and view all the answers

What are common neurogenic symptoms associated with hypoglycemia in neonates?

<p>Jitteriness, irritability, and tachypnea (B)</p> Signup and view all the answers

What is a characteristic of glucose levels in breastfed term neonates compared to formula-fed neonates?

<p>Lower glucose levels but higher ketone levels (A)</p> Signup and view all the answers

Which of the following is NOT a risk factor for neonatal hypoglycemia?

<p>Excessive ketogenesis (A)</p> Signup and view all the answers

What are potential symptoms of hypoglycemia beyond poor suck and seizures in neonates?

<p>High pitched cry and cyanosis (D)</p> Signup and view all the answers

Which enzyme defect can lead to unconjugated hyperbilirubinemia in neonates?

<p>Glucuronyl transferase deficiency (B)</p> Signup and view all the answers

What is a common cause of bleeding-related RBC hemolysis leading to hyperbilirubinemia in neonates?

<p>Blood group incompatibility (D)</p> Signup and view all the answers

Which condition is characterized by dark/hyperpigmented urine and pale/acholic stools in neonates?

<p>Biliary atresia (C)</p> Signup and view all the answers

What is the primary effect of breast milk on the liver enzyme required for bilirubin metabolism?

<p>Inhibits Glucuronyl transferase (C)</p> Signup and view all the answers

Which syndrome is characterized by a total lack of glucuronyl transferase?

<p>Crigler-Najjar syndrome type 1 (A)</p> Signup and view all the answers

Which factor increases the risk of kernicterus in neonates?

<p>Asphyxia (C)</p> Signup and view all the answers

What should be done if a neonate presents with jaundice at more than 2 weeks of age?

<p>Order a bilirubin test for conjugated hyperbilirubinemia and rule out biliary atresia (D)</p> Signup and view all the answers

What was the primary discovery related to the use of phototherapy for jaundice in neonates?

<p>'Phototherapy was discovered accidentally at Rochford Hospital' (C)</p> Signup and view all the answers

Which of the following is NOT a symptom of severe hypoglycemia in infants?

<p>Jaundice (C)</p> Signup and view all the answers

What is the primary risk associated with visible jaundice before discharge at any age?

<p>Severe hyperbilirubinemia (A)</p> Signup and view all the answers

What is the primary physiological effect of unconjugated bilirubin in neonates?

<p>Neurotoxicity (D)</p> Signup and view all the answers

Which statement accurately describes the progression of visible jaundice due to hyperbilirubinemia?

<p>Progresses from head to toes/soles (D)</p> Signup and view all the answers

What is the main reason for administering dextrose gel as a management strategy in infants with hypoglycemia?

<p>To raise blood glucose levels (A)</p> Signup and view all the answers

What is the potential consequence of pathological hyperbilirubinemia in neonates if left untreated?

<p>Seizures (C)</p> Signup and view all the answers

Which of the following is NOT a risk factor for hyperbilirubinemia in neonates?

<p>Full-term gestation (B)</p> Signup and view all the answers

How does unconjugated bilirubin differ from conjugated bilirubin in terms of neurotoxicity?

<p><strong>Unconjugated</strong> bilirubin can cross the blood-brain barrier and is neurotoxic. (D)</p> Signup and view all the answers

What is the importance of maintaining glucose homeostasis for neonates?

<p>Ensures a smooth transition to extrauterine life (A)</p> Signup and view all the answers

Which event is critical for a smooth transition to extrauterine life in neonates?

<p>Maintenance of glucose homeostasis (B)</p> Signup and view all the answers

What can untreated hypoglycemia and hyperbilirubinemia lead to in neonates?

<p>Long-term complications (B)</p> Signup and view all the answers

What is the primary physiological effect of unconjugated bilirubin in neonates?

<p>Neurotoxicity (C)</p> Signup and view all the answers

Which factor influences the severity of neonatal jaundice?

<p>Gestational age (C)</p> Signup and view all the answers

Why is it crucial to identify abnormalities in transition in neonatal care?

<p>To correlate with potential diseases (B)</p> Signup and view all the answers

What are the potential complications of untreated hypoglycemia and hyperbilirubinemia in neonates?

<p>Increased risk of long-term consequences (A)</p> Signup and view all the answers

What are some signs that a neonate may present with if experiencing hypoglycemia or hyperbilirubinemia?

<p>Hypotonia and poor feeding (D)</p> Signup and view all the answers

What is the main source of energy for the cerebral cells?

<p>Glucose (C)</p> Signup and view all the answers

During the 1st hour of life, what metabolic shift occurs in terms of energy utilization?

<p>Shift from glucose to a significant contribution by fat (A)</p> Signup and view all the answers

Which neonates have lower glucose levels but higher ketone levels compared to formula-fed neonates?

<p>Small for gestational age (SGA) infants (B)</p> Signup and view all the answers

Which condition may present with poor suck, poor feeding, and seizures in neonates?

<p>Hypoglycemia (D)</p> Signup and view all the answers

What is the primary factor that increases the risk of neonatal hypoglycemia according to the text?

<p>Excessive insulin production (B)</p> Signup and view all the answers

What is the recommended blood glucose level threshold for starting enteral supplementation in asymptomatic infants?

<p>&lt; 2.5 mmol/L (B)</p> Signup and view all the answers

What medical syndrome characterized by dark urine and pale stools can lead to neonatal hypoglycemia?

<p>Galactosemia (C)</p> Signup and view all the answers

Why are breastfed term neonates able to tolerate lower glucose levels without clinical manifestations compared to formula-fed infants?

<p>Increased reliance on ketones as an energy source (D)</p> Signup and view all the answers

What are the potential long-term neurological outcomes associated with neonatal hypoglycemia?

<p>Learning disabilities and seizure disorders (D)</p> Signup and view all the answers

How does physiological hyperbilirubinemia differ from pathological hyperbilirubinemia?

<p>Age of onset (D)</p> Signup and view all the answers

Which physiological process contributes to the risk of pathological hyperbilirubinemia in neonates?

<p>Increased RBC mass (D)</p> Signup and view all the answers

What is the primary source of energy for cerebral cells in neonates?

<p>Glucose (C)</p> Signup and view all the answers

Which factor is NOT associated with an increased risk of neonatal hypoglycemia?

<p>Previous sibling with severe hyperbilirubinemia (A)</p> Signup and view all the answers

What is the role of unconjugated bilirubin in terms of its neurotoxicity?

<p>Crosses the blood-brain barrier and is neurotoxic (C)</p> Signup and view all the answers

Which enzyme defect can lead to unconjugated hyperbilirubinemia in neonates?

<p>Glucuronyl transferase (D)</p> Signup and view all the answers

How does late preterm status relate to the risk of hypoglycemia in neonates?

<p>&lt; 38 wks gestation increases the risk of severe hypoglycemia (A)</p> Signup and view all the answers

What is the primary cause of unconjugated hyperbilirubinemia in neonates due to an inadequate breast milk supply?

<p>Enzyme defect (D)</p> Signup and view all the answers

Which condition is characterized by a partial deficiency of glucuronyl transferase in neonates?

<p>Crigler-Najjar syndrome type 2 (C)</p> Signup and view all the answers

What anatomical abnormality in neonates should never be missed as it greatly affects survival if operated on early?

<p>Biliary atresia (A)</p> Signup and view all the answers

Which enzyme deficiency can lead to conjugated hyperbilirubinemia in neonates?

<p>Glucuronyl transferase (B)</p> Signup and view all the answers

What is the main reason behind unconjugated hyperbilirubinemia in neonates with spherocytosis or elliptocytosis?

<p>Hemoglobin defect (D)</p> Signup and view all the answers

Which factor can cause an increased risk for kernicterus in neonates?

<p>Toxic sepsis (C)</p> Signup and view all the answers

What can cause Cconjugated Hyperbilirubinemia in neonates due to Anatomical abnormalities?

<p>BILIARY ATRESIA (D)</p> Signup and view all the answers

What enzyme defect can cause unconjugated hyperbilirubinemia in neonates with Asian males?

<p>G6PD (A)</p> Signup and view all the answers

What is the most effective type of light used in phototherapy for neonatal jaundice?

<p>Blue-green light (A)</p> Signup and view all the answers

How are configurational and structural isomers excreted from the body?

<p>In bile without glucorinidation in the liver (B)</p> Signup and view all the answers

What is the process involved in an exchange transfusion for neonates?

<p>Slowly removing the baby's blood and replacing it with fresh donor blood (C)</p> Signup and view all the answers

What is a common complication associated with exchange transfusion in neonates?

<p>Blood clots (B)</p> Signup and view all the answers

What is the main consequence of pathological hyperbilirubinemia in neonates if left untreated?

<p>Brain damage (kernicterus) (B)</p> Signup and view all the answers

What are some complications associated with severe neonatal jaundice that may require treatment beyond phototherapy?

<p>Hyper-/hypo-kalemia, hypocalcemia, and abnormal acid-base balance (C)</p> Signup and view all the answers

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